An assessment of acoustic contrast between long and short vowels using convex hulls

An alternative to the spectral overlap assessment metric (SOAM), first introduced by Wassink [(2006). J. Acoust. Soc. Am. 119(4), 2334–2350], is introduced. The SOAM quantifies the intra- and inter-language differences between long–short vowel pairs through a comparison of spectral (F1, F2) and temporal properties modeled with best fit ellipses (F1 × F2 space) and ellipsoids (F1 × F2 × duration). However, the SOAM ellipses and ellipsoids rely on a Gaussian distribution of vowel data and a dense dataset, neither of which can be assumed in endangered languages or languages with limited available data. The method presented in this paper, called the Vowel Overlap Assessment with Convex Hulls (VOACH) method, improves upon the earlier metric through the use of best-fit convex shapes. The VOACH method reduces the incorporation of “empty” data into calculations of vowel space. Both methods are applied to Numu (Oregon Northern Paiute), an endangered language of the western United States. Calculations from the VOACH method suggest that Numu is a primary quantity language, a result that is well aligned with impressionistic analyses of spectral and durational data from the language and with observations by field researchers

An Explanation of Base TETU Effects in Kwak'wala and Cupeño

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Using Qualitative Methods to Improve Physician Research Training: Understanding the Student Perspective

For several decades now, physician-scientists have been referred to as an “endangered species.” Many factors have contributed to the dearth of clinical investigators, and training programs in clinical research are just one tool in a multi-pronged strategy to increase the number of successful physician-scientists working in health research. A qualitative approach that analyzes students’ educational goals and experiences can help fill the gaps in our knowledge about how best to train aspiring physician-scientists. This study was an interpretive phenomenology that evaluated the Master of Science program in Clinical and Translational Research (MSCTR) at the University of Cincinnati. The purpose of the study was to allow students to articulate their expectations, needs, and experiences in the MSCTR. The study included a group level assessment (GLA) and document review. Findings suggest several reasons students enrolled in the MSCTR, as well as some areas for improvement in the program: more physician-centered classes, a more directed curriculum, and a more cohesive course plan overall. Conclusions from these recommendations are that student perspectives can inform decisions around curricula and instructional methods in powerful ways, particularly when combined with a qualitative methodological approach. This study revealed several insights into how faculty and administrators can more effectively train physicians in research methodology. Training should be as applied and relevant as possible to make it directly applicable to clinical practice. This goal could be enhanced if classes – particularly statistics classes – were more physician-oriented. The curriculum of a clinical research training program for clinicians should be clear and directed, but with some flexibility and space within the curriculum for classes within areas of specialization. Collaboration should be integrated throughout, and courses should follow a logical, interconnected sequence

Reviewer Acknowledgments for 2019

The Editorial Team extends a heart-felt “thank you” to those who have given their time and expertise in the past year to participate in this process with the Journal of Appalachian Health. We know that you have many competing pressures on your time, and that you are not financially compensated for the time you spend reviewing manuscripts. We hope that there are other forms of compensation that make the sacrifice worth the effort

Serum Cotinine versus Parent Reported Measures of Secondhand Smoke Exposure in Rural Appalachian Children

Background: Secondhand smoke (SHS) exposure in Appalachian children and associated adverse effects is understudied and not well documented. This study assessed the prevalence of SHS exposure in Appalachian children by parental self-report and internal biological measure. Methods: SHS exposure was determined in children residing in rural Appalachian communities during their participation in the Communities Actively Researching Exposure Study between 2009 and 2013. Parents reported the number of smokers in the household and number of cigarettes smoked/day. Children ages 7-9 provided a serum sample for cotinine analysis. Parent reported measures and child serum cotinine measures of SHS exposure were compared with national and Appalachian-state estimates. Data analysis for the study was done in 2013. Results: Approximately 37% parents reported at least one smoker in the home, yet 50% of children had a detectible level of cotinine in serum. The mean serum cotinine level in children was 0.7 + 1.6 ng/mL. In homes of at least one reported smoker, an average of 20 cigarettes were smoked//day. Compared to 7.6% children, aged 3-19 years, exposed to SHS nationally, 36.6% children in our study were exposed to SHS living in Appalachian counties. Implications: Children living in rural Appalachian counties are significantly exposed to SHS exposure. Parental self-reports of smoking underestimates child exposure to SHS as measured by serum cotinine levels. Developing risk communication messages and implementing culturally appropriate interventions aimed at reducing tobacco dependence in rural Appalachian regions should be explored

Association of Manganese Biomarker Concentrations with Blood Pressure and Kidney Parameters among Healthy Adolescents: NHANES 2013–2018

Deficiency or excess exposure to manganese (Mn), an essential mineral, may have potentially adverse health effects. The kidneys are a major organ of Mn site-specific toxicity because of their unique role in filtration, metabolism, and excretion of xenobiotics. We hypothesized that Mn concentrations were associated with poorer blood pressure (BP) and kidney parameters such as estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN), and albumin creatinine ratio (ACR). We conducted a cross-sectional analysis of 1931 healthy U.S. adolescents aged 12–19 years participating in National Health and Nutrition Examination Survey cycles 2013–2014, 2015–2016, and 2017–2018. Blood and urine Mn concentrations were measured using inductively coupled plasma mass spectrometry. Systolic and diastolic BP were calculated as the average of available readings. eGFR was calculated from serum creatinine using the Bedside Schwartz equation. We performed multiple linear regression, adjusting for age, sex, body mass index, race/ethnicity, and poverty income ratio. We observed null relationships between blood Mn concentrations with eGFR, ACR, BUN, and BP. In a subset of 691 participants, we observed that a 10-fold increase in urine Mn was associated with a 16.4 mL/min higher eGFR (95% Confidence Interval: 11.1, 21.7). These exploratory findings should be interpreted cautiously and warrant investigation in longitudinal studies

Delivering health knowledge and wisdom from the hills and hollows of Appalachia

There is knowledge in the pages of Appalachia’s hills. This journal is positioned to find and publish those translations. It grows from a need to provide an outlet for scholarship about Appalachia’s health so that knowledge, and occasionally wisdom, is shared with those who care about and are committed to improving the region’s health

Impact of the COVID-19 Shutdown on Mental Health in Appalachia by Working Status

Introduction: To slow the spread of COVID-19 in the United States, businesses shutdown in Spring 2020. Research has indicated the impact on frontline workers, yet little is known about the impact on those who were not working outside the home or switched to working remotely. Purpose: The purpose of this report is to identify the financial and healthcare issues and mental health impact of the COVID-19 shutdown on Appalachians by worker categories. Methods: An online survey was administered from May 8 – June 6, 2020 to a convenience sample of previous research participants and shared through social media networks, i.e., snowball sampling. Questions investigated mental health, financial and healthcare issues, and employment status. Survey responses were summarized by percentages overall and by working categories. Results: Of the 751 participants, 276 (42%) resided in Appalachia. After removing 17 who lost their job due to COVID-19, 59 (23%) indicated not working outside the home prior to COVID-19, whereas 111 (43%) and 89 (34%) switched to working remotely and continued working outside the home during the shutdown. Respondents were predominately Caucasian and female. Nearly a quarter of participants had lost or reduced income due to the shutdown. Approximately half missed or postponed healthcare appointments. Mental health impacts were similar across the groups, with half of the respondents reporting anxiety due to COVID-19. Implications: Further research is needed to explore health outcomes associated with missed healthcare appointments during the shutdown. Mental health support may be needed equally by those isolated at home and frontline workers